Individual provider Active NPI

Tara Birke, NP (APRN)

  • Nurse Practitioner
  • Saint Charles, MO
National Provider Identifier
1619412962
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2016012553 Issued in MO
Practice address
1475 Kisker Rd Ste 200
Saint Charles, MO 63304-8788
Phone
(636) 498-7880
Fax
(636) 498-7889
NPI assigned
Dec 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2016012553 MO Primary

Addresses

Primary practice location

1475 Kisker Rd Ste 200
Saint Charles, MO 63304-8788

Mailing address

10330 Old Olive Street Rd
Saint Louis, MO 63141-5933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231218000883 MO Practitioner - Nurse Practitioner 9830548767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

1475 Kisker Rd
Suite 200
Saint Charles, MO 63304-8788
Phone (636) 498-5850

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group, Inc. CurrentSince Dec 14, 2023 Accepting new patients
SSM Medical Group Inc. CurrentSince Dec 14, 2023 Accepting new patients

Locations

1475 Kisker Rd
Ste 200
Saint Charles, MO 63304
Phone (636) 498-5800

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

Interoperability endpoints

  • Direct secure messaging: tbirke497132@direct-ehr-ssmhc.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1482364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1619412962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10330 OLD OLIVE STREET RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 KISKER RD STE 200",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633048788",
            "telephone_number": "636-498-7880",
            "fax_number": "636-498-7889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRKE",
        "first_name": "TARA",
        "credential": "NP (APRN)",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-22",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2016012553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

Verify at the official NPI Registry.